Initial Accommodation Request

* indicates a required field

Student Intake Form

Ocean County College values diversity and inclusion within its campus community and seeks to provide an affirming environment for all its students. The Office of Disability Services (“Disability Services”) provides the opportunity for you to disclose your disability status, as well as to request any needed accommodations or services.

This Intake Form is for students with a documented disability who want to register for reasonable accommodations and services with Disability Services.

When completing the form, please answer the questions as accurately and thoroughly as possible so that we may process your request in a timely manner. It should take you approximately 15 minutes to complete the form and upload supporting documentation.

Upon completion of the form, a representative from our office will contact you within 5 business days. If you have not heard from us after that time, please contact Disability Services at

Ocean County College is an equal access/equal opportunity institution. Individuals with disabilities are encouraged to direct suggestions, comments, or complaints concerning any accessibility issues with this form and/or website to

Legal first name
Legal last name
If you have a preferred name, do you want us to use the preferred name in all correspondence from our office?Required
This includes, but is not limited to, emails and notice on your official Accommodation Letter.

If you do not know you OCC Student ID, contact the Hub for assistance at 732-255-0482 or email

Please use your college issued email address

Emergency Preparedness

As a result of your disability, do you require the use of an elevator for access? Required
Can you go up/down stairs?Required
Will you require assistance in an emergency situation?Required
Are you currently receiving services from another support or rehabilitation agency? Choose from the following:

Specific Accommodation Information

If unsure, type "unknown"

If unsure, type "unknown"

Upload supporting document(s)

Upload supporting documents at this time. Failure to upload supporting documentation of disability will result in a delay of processing your request. Examples of supporting documentation include, but are not limited to: 

  • VA Benefit Summary Letter (including disability information) 
  • Most recent High School Individual Education Plan (IEP), including the full Psychological and Educational Evaluation and Summary of Performance (within 3 years) 
  • Accommodation plan from another post-secondary institution 
  • Assessment with diagnoses from a certified or licensed professional qualified in the appropriate specialty area (e.g. school psychologist, neuropsychologist, clinical psychologist, audiologist, ophthalmologist, learning disability specialist (LDT-C),
  • Most recent evaluation performed by the Division of Vocational Rehabilitation Services (DVRS) (within 3 years) 
Are you completing this form for yourself or on behalf of someone else?Required